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|Developmental Counseling FORM |
|For use of this form see FM 22-100. |
|DATA REQUIRED BY THE PRIVACY ACT OF 1974|
|Authority: 5 USC 301, Departmental Regulations; 10 USC 3013, Secretary of the Army and E.O. 9397 (SSN) |
|PRINCIPAL PURPOSE: To assist leaders in conducting and recording counseling data pertaining to subordinates. |
|ROUTINE USES: For subordinate leaderdevelopment IAW FM 22-100. Leaders should use this form as necessary. |
|DISCLOSURE: Disclosure is voluntary. |
|Part I - Administrative Data|
|Name (Last, First, MI) |Rank / Grade |Social Security No. |Date of Counseling |
| |SPC / E-4 |XXX-XX- |8 DEC 2009 |
|Organization|Name and Title of Counselor |
|6-6 Cavalry, Echo Troop, Fort Drum, NY 13601 |Name / Squad Leader |
|PART II - Background Information |
|Purpose of Counseling:(Leader states the reason for the counseling, e.g. Performance/Professional or Event-Oriented counseling and includes the |
|leaders facts and observations prior to the counseling): |
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|Welcome the Soldier as a member of the Maintenance Platoon |
|Conduct initial counseling |
|Encourage open communication|
|Provide the Soldier the opportunity to surface any issues |
|Provide guidance on 10th Division/10th CAB /6-6 CAV/Echo Troop/Platoon standards, and my expectations |
|PartIII - Summary of Counseling |
|Complete this section during or immediately subsequent to counseling. |
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|Key Points of Discussion: |
| |
|NOTE: New Leadership was assigned to the...
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